Changes of cardiovascular risk factors and their implications in subsequent birth cohorts of older adults in Germany: a life course approach.

BACKGROUND: To examine lifetime patterns of cardiovascular risk factors and their implications in subsequent birth cohorts of older adults in Germany, who experienced very different political and socioeconomic conditions at various phases of their lives. DESIGN AND METHODS: Participants of the ESTHER study, a statewide cohort study conducted in Saarland, Germany, were categorized into four birth cohorts: 1925-1934, 1935-1939, 1940-1944, 1945-1952. At baseline, lifetime history of body weight, physical activity, smoking and drinking habits, and of physician-diagnosed diabetes mellitus were documented. The average BMI, the average number of hours of physical activity, prevalence of smoking and alcohol consumption between ages 20 and 50 years were assessed. The relative risks of a first diagnosis of diabetes mellitus before or at the age of 50 years by birth cohorts were assessed by multiple logistic regressions controlling for education and BMI at the age of 20.
RESULTS: For both men and women, later birth cohorts had considerably worse lifestyle profiles. The frequency of diabetes mellitus up to the age of 50 years was much higher in the later than in the earlier cohorts. The increase was more pronounced among men than among women.
CONCLUSION: Women and men reaching old age in the forthcoming years have more unfavourable lifetime risk factor profiles than earlier birth cohorts. These patterns might have substantial implications for the future burden of chronic disease.